Brook Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has changed to requires Improvement: This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People or their relatives raised no concerns relating to their pre-admission assessment process. Although new admissions to the service were currently suspended the manager was experienced and knowledgeable in regard to following the admissions process to ensure a safe transition to the service taking into account not only the needs of the person but the needs of existing people living at the service. The manager had meetings with relatives and people to review care needs whilst transferring care plans to the electronic system, ensuring all information was both accurate and up to date .

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Most people told us they felt the quality of their care was good. People were complimentary about the food choices and portion sizes, as this had been one of the concerns raised to us previously regarding people not receiving enough to eat. People’s comments included, “Sunday we have a lovely roast. I never feel hungry have mid-morning tea and coffee,” and “The food is ok, much better than it used to be. I did used to feel hungry but do not now a days.” Observations carried out at lunchtime showed good portions and choice available to people. One person asked for more pudding, and this bought out to them. The new cook came out to speak to people and explained they would be asking them what their food likes and dislikes were. The presentation of people’s meals served to them was good, however the presentation of people’s pureed meals could be further improved. We observed these being taken to people’s rooms in small plastic round bowls mixed together which looked very unappetising. We discussed with the manager the use of moulds for pureed foods so the pureed meals could be well presented. For example, pureed meats placed in moulds to replicate the shape of a chop or sausage. After our assessment visit for those people identified with dysphagia the manager had ordered in readymade meals according to people’s individual modified dietary requirements to ensure their meals were more visually appealing. The manager had begun to collate an overview of people’s weights for November and December 2024 to monitor for any weight loss/gain. This meant the manager had oversight of any gains or losses of weight people had and could take action straight away.

The provider had not always worked effectively across teams and services to support people. They had not always shared their assessment of people’s needs when people moved between different services. The manager told us how they had been working with staff, to ensure the needs of people using the service were understood. Although there was further work to do, they had made it a priority to ensure risks to people and information on how to support them was current and up to date to share with relevant partner agencies when required. Staff told us referrals made to other services such as the district nurse or speech and language therapists were made by the GP, and any changes are updated in the person’s care plan. A professional told us, “Staff now provide comprehensive details about people during visits, ensuring all relevant information is communicated. This has improved with the new management and training initiatives. Staff are now more aware about people’s needs.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. People and staff told us and from our own observation there was very little stimulating group or individual activities for people. We observed very little interaction from staff other than task focused engagement. Although staff were kind and polite and attentive to people’s needs there was no other conversations and general chatting. People told us, “I would love to go out for a coffee but have not been out for a long time, “and “Sometimes they have things going on and I do join in.” A member of staff told us, “Residents here do need some outings as they do not go out much. Although some days we play games, sing, watch football, films.” The manager told us they recognised the need for more social engagement and activities for people and had successfully recruited an experienced activity coordinator to work together with people using the service to plan activities and outings on a regular basis. The service also had its own minibus for outings and attending appointments when needed, however the manager told us this did not have a tailgate lift so was only accessible for people who were independently mobile meaning people who had poor mobility or who were not mobile would be at risk of not having the same access to enjoying trips outside of the service should they want to.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. People we spoke with told us their needs were being met and overall enjoyed living at the service. Relative’s comments were positive about improvements being undertaken and communication. One relative told us, “I have seen vast improvements in the home and in the care since the new manager took over, I am always given a call if [person] is unwell, and I had a link recently from them to do a review on [persons] care.” The manager told us, “When I first started, I spent the first week observing and listening when completing my daily walk rounds. When relatives came in, I met with them to obtain additional information to formulate information for people’s care plans.” With the implementation of the electronic care plans these were now reviewed regularly as part of the manager’s quality assurances processes. Care reviews were undertaken to ensure continuous improvements were made to people’s care and treatment when required. Further improvements were required in relation to the monitoring and oversight of all people on fluid charts. Information should be clear in the care plans as to what the person’s individualised target should be, what actions to be taken over what period of time should a person not attain their target. We saw no evidence of actions target when we identified low fluid intake for people over a week which could potentially place people at risk of dehydration, although on the day of our visit drinks were readily available throughout the day and we had no concerns raised to us by people or their relatives.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. People told us they were able to make their own choices. People were observed to move around the home freely. A person told us, “I can shower when I want, go to bed when I want to, I am well looked after.” There were processes in place to assess people’s capacity to make decisions and where appropriate Deprivation of Liberty Safeguards (DoLS) had recently been applied for in people’s best interests with involvement from their representative lawfully acting on their behalf as the decision maker. However, further improvements were required to ensure MCAs were completed for people with bedrails in situ to demonstrate the least restrictive option had been considered in the best interests of the person. After our assessment visit the manager provided evidence to confirm these were now in place for people. Staff were clear about the importance of obtaining consent from people. A member of staff told us, “I always ask people what they want and explain what I am doing. With [name of person] I use gestures for communication. Most people here are able to give their consent.”